Jae Ko, DDS

NPI #1013106830 in Chicago, Illinois

Provider Information

NPI Number: 1013106830
Entity Type: Individual
Name: Jae Ko, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Oct 17, 2007
Last Updated: May 2, 2015

Practice Location

Address: 3434 W PETERSON AVE
Address 2: SUITE 1D
City: Chicago
State: Illinois
ZIP Code: 60659-3319
Phone: (872) 208-7573

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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